Takano Hajime, Obata Jyun-ei, Kodama Yasushi, Kitta Yoshinobu, Nakamura Takamitsu, Mende Akira, Kawabata Ken-ichi, Saito Yukio, Fujioka Daisuke, Kobayashi Tsuyoshi, Yano Toshiaki, Sano Keita, Kugiyama Kiyotaka
Department of Internal Medicine II, University of Yamanashi, Chuo City, Yamanashi Prefecture, Japan.
Int J Cardiol. 2009 Feb 20;132(2):221-6. doi: 10.1016/j.ijcard.2007.11.040. Epub 2008 Jan 14.
Plasma levels of adiponectin are decreased in patients with ischemic heart disease, but increased in patients with heart failure (HF). The source of increased adiponectin levels in patients with HF remains unknown. This study examined whether adiponectin, an adipocyte-derived protein with cardioprotective actions, is released from the heart in patients with HF.
Plasma adiponectin levels sampled from the aorta, coronary sinus (CS), and peripheral vein (PV) were measure by ELISA in 138 consecutive patients with left ventricular ejection fraction (LVEF) <40% and in 40 normal controls.
PV adiponectin levels were significantly higher in patients with either non-ischemic HF (n=81) or ischemic HF (n=57) than controls; levels were similar between patients with non-ischemic HF and those with ischemic HF. There was a significant step-up in adiponectin levels from the aorta to the CS in patients with either non-ischemic HF or ischemic HF but not in controls. The CS-aorta difference in adiponectin levels, which reflect cardiac release of adiponectin, positively correlated with PV levels in patients with either non-ischemic HF or ischemic HF. The CS-aorta difference in adiponectin levels positively correlated with PV levels of brain natriuretic peptide and inversely with LVEF in patients with either non-ischemic HF or ischemic HF.
Adiponectin is released from the heart into the peripheral circulation in proportion to the extent of LV dysfunction in patients with HF irrespective of etiologies of HF.
缺血性心脏病患者的血浆脂联素水平降低，但心力衰竭（HF）患者的血浆脂联素水平升高。HF患者脂联素水平升高的来源尚不清楚。本研究探讨了脂联素这种具有心脏保护作用的脂肪细胞衍生蛋白在HF患者中是否从心脏释放。
通过酶联免疫吸附测定法（ELISA）测量了138例连续的左心室射血分数（LVEF）<40%的患者以及40例正常对照者从主动脉、冠状窦（CS）和外周静脉（PV）采集的血浆脂联素水平。
非缺血性HF患者（n = 81）或缺血性HF患者（n = 57）的PV脂联素水平显著高于对照组；非缺血性HF患者和缺血性HF患者的脂联素水平相似。非缺血性HF患者或缺血性HF患者从主动脉到CS的脂联素水平有显著升高，而对照组则无。脂联素水平的CS-主动脉差异反映了脂联素的心脏释放，在非缺血性HF患者或缺血性HF患者中与PV水平呈正相关。在非缺血性HF患者或缺血性HF患者中，脂联素水平的CS-主动脉差异与脑钠肽的PV水平呈正相关，与LVEF呈负相关。
无论HF的病因如何，脂联素在HF患者中均会根据左心室功能障碍的程度从心脏释放到外周循环中。
